Why is this medication prescribed?

Doxycycline is used to treat infections caused by bacteria, including pneumonia and other respiratory tract infections; certain infections of the skin or eye; infections of the lymphatic, intestinal, genital, and urinary systems; and certain other infections that are spread by ticks, lice, mites, infected animals, or contaminated food and water. It is also used along with other medications to treat acne. Doxycycline is also used to treat or prevent anthrax (a serious infection that may be spread on purpose as part of a bioterror attack), in people who may have been exposed to anthrax in the air, and to treat plague and tuleramia (serious infections that may be spread on purpose as part of a bioterror attack). It is also used to prevent malaria. Doxycycline can also be used in people who cannot be treated with penicillin to treat certain types of food poisoning. Doxycycline (Oracea) is used only to treat pimples and bumps caused by rosacea (a skin disease that causes redness, flushing, and pimples on the face). Doxycycline is in a class of medications called tetracycline antibiotics. It works to treat infections by preventing the growth and spread of bacteria. It works to treat acne by killing the bacteria that infects pores and decreasing a certain natural oily substance that causes acne. It works to treat rosacea by decreasing the inflammation that causes this condition.

Antibiotics such as doxycycline will not work for colds, flu, or other viral infections. Using antibiotics when they are not needed increases your risk of getting an infection later that resists antibiotic treatment.

How should this medicine be used?

Doxycycline comes as a capsule, delayed-release capsule, tablet, delayed-release tablet, and suspension (liquid) to take by mouth. Doxycycline is usually taken once or twice a day. Drink a full glass of water with each dose. If your stomach becomes upset when you take doxycycline, you may take it with food or milk. However, taking doxycycline with milk or food may decrease the amount of medication absorbed from your stomach. Talk with your doctor or pharmacist about the best way to take doxycycline. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take doxycycline exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Swallow the delayed-release tablets and the Acticlate CAP capsules whole; do not split, chew, or crush them.

If you cannot swallow certain delayed-release tablets (Doryx; generics) whole, carefully break up the tablet and sprinkle the contents of the tablet on a spoonful of cold or room temperature (not hot) applesauce. Be careful not to crush or damage any of the pellets while you are breaking up the tablet. Eat the mixture right away and swallow without chewing. If the mixture cannot be eaten right away it should be discarded.

Shake the suspension well before each use to mix the medication evenly.

If you are taking doxycycline for the prevention of malaria, start taking it 1 or 2 days before traveling to an area where there is malaria. Continue taking doxycycline each day you are in the area, and for 4 weeks after leaving the area. You should not take doxycycline for the prevention of malaria for more than 4 months.

Continue to take doxycycline even if you feel well. Take all the medication until you are finished, unless your doctor tells you otherwise.

One doxycycline product may not be able to be substituted for another. Be sure that you receive only the type of doxycycline that was prescribed by your doctor. Ask your pharmacist if you have any questions about the type of doxycycline you were given.

Other uses for this medicine

Doxycycline may also be used for the treatment of malaria. It may also be used to treat Lyme disease or to prevent Lyme disease in certain people who have been bitten by a tick. It may also be used to prevent infection in people who were sexually attacked. Talk to your doctor about the possible risks of using this medication for your condition.

This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.

What special precautions should I follow?

Before taking doxycycline,

tell your doctor and pharmacist if you are allergic to doxycycline, minocycline, tetracycline, demeclocycline, any other medications, sulfites, or any of the ingredients in doxycycline capsules, extended-release capsules, tablets, extended-release tablets, or suspension. Ask your pharmacist for a list of the ingredients.

tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, and nutritional supplements you are taking or plan to take. Be sure to mention any of the following: acitretin (Soriatane); anticoagulants ('blood thinners') such as warfarin (Coumadin, Jantoven); barbiturates such as butabarbital (Butisol), phenobarbital, and secobarbital (Seconal); bismuth subsalicylate; carbamazepine (Epitol, Tegretol, others); isotretinoin (Absorica, Amnesteem, Clavaris, Myorisan, Zenatane); penicillin; phenytoin (Dilantin, Phenytek); and proton pump inhibitors such as dexlansoprazole (Dexilant), esomeprazole (Nexium, in Vimovo), lansoprazole (Prevacid, in Prevpac), omeprazole (Prilosec, in Yosprala, Zegerid), pantoprazole (Protonix), and rabeprazole (Aciphex). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.

be aware that antacids containing magnesium, aluminum, or calcium, calcium supplements, iron products, and laxatives containing magnesium interfere with doxycycline, making it less effective. Take doxycycline 2 hours before or 6 hours after taking antacids, calcium supplements, and laxatives containing magnesium. Take doxycycline 2 hours before or 4 hours after iron preparations and vitamin products that contain iron.

tell your doctor if you have or have ever had lupus (condition in which the immune system attacks many tissues and organs including the skin, joints, blood, and kidneys), intracranial hypertension (pseudotumor cerebri; high pressure in the skull that may cause headaches, blurry or double vision, vision loss, and other symptoms), a yeast infection in your mouth or vagina, surgery on your stomach, asthma, or kidney or liver disease.

you should know that doxycycline may decrease the effectiveness of hormonal contraceptives (birth control pills, patches, rings, or injections). Talk to your doctor about using another form of birth control.

tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. If you become pregnant while taking doxycycline, call your doctor immediately. Doxycycline can harm the fetus.

plan to avoid unnecessary or prolonged exposure to sunlight and to wear protective clothing, sunglasses, and sunscreen. Doxycycline may make your skin sensitive to sunlight. Tell your doctor right away if you get a sunburn.

you should know that when you are receiving doxycycline for prevention of malaria, you should also use protective measures such as effective insect repellent, mosquito nets, clothing covering the whole body, and staying in well-screened areas, especially from early nighttime until dawn. Taking doxycycline does not give you full protection against malaria.

you should know that when doxycycline is used during pregnancy or in babies or children up to 8 years of age, it can cause the teeth to become permanently stained. Doxycycline should not be used in children under 8 years of age except for inhalational anthrax, Rocky Mountain spotted fever, or if your doctor decides it is needed.

What special dietary instructions should I follow?

Unless your doctor tells you otherwise, continue your normal diet.

What should I do if I forget a dose?

Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

What side effects can this medication cause?

Doxycycline may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

nausea

vomiting

diarrhea

loss of appetite

itching of the rectum or vagina

sore or irritated throat

swollen tongue

dry mouth

anxiety

back pain

changes in color of skin, scars, nails, eyes, or mouth

Some side effects can be serious. If you experience any of these symptoms, call your doctor immediately:

headache

blurred vision, seeing double, or loss of vision

rash that may occur with fever or swollen glands

hives

skin redness, peeling or blistering

difficulty breathing or swallowing

swelling of the eyes, face, throat, tongue, or lips

unusual bleeding or bruising

watery or bloody stools, stomach cramps, or fever during treatment or for up to two or more months after stopping treatment

a return of fever, sore throat, chills, or other signs of infection

joint pain

chest pain

discoloration of permanent (adult) teeth

Doxycycline may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

What should I know about storage and disposal of this medication?

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from light and excess heat and moisture (not in the bathroom).

It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.

In case of emergency/overdose

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.

What other information should I know?

Keep all appointments with your doctor and laboratory. Your doctor will want to check your response to doxycycline.

Before having any laboratory test, tell your doctor and the laboratory personnel that you are taking doxycycline.

Do not let anyone else take your medication. Your prescription is probably not refillable. If you still have symptoms of infection after you finish the doxycycline, call your doctor.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.